Provider Demographics
NPI:1467195461
Name:AHMEDUDDIN, OBEID (DO)
Entity Type:Individual
Prefix:
First Name:OBEID
Middle Name:
Last Name:AHMEDUDDIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MARC DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-1388
Mailing Address - Country:US
Mailing Address - Phone:848-702-2043
Mailing Address - Fax:
Practice Address - Street 1:66 MARC DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-1388
Practice Address - Country:US
Practice Address - Phone:848-702-2043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program